Loneliness and mental health in a representative sample of community-dwelling Spanish older adults

Research seems to support loneliness as a risk factor for mental health problems in the elderly. Most studies analyzing the effects of loneliness on older adults' mental health have relied on convenience samples. In this study, the prevalence and predictors of feelings of loneliness were studied in a representative sample of 272 community-dwelling Spanish older adults. The potential of feelings of loneliness to significantly contribute to the explanation of mental health of the elderly was also explored. The percentage of people reporting feelings of loneliness was 23.1%. Being a woman, being older, living alone, having fewer economic resources, having lower perceived health, and being dissatisfied with the frequency of contact with relatives and friends were found to be significant predictors of feelings of loneliness. Loneliness contributed significantly to the explanation of mental health, even when other significant variables were statistically controlled. The results of this study suggest that loneliness is a relevant factor for the analysis and understanding of mental health in the elderly.     

Loneliness and psychological health of orthopaedic patients’ caregivers: does gender make a difference?

Although research evidence indicates that loneliness is detrimental to mental health in diverse populations, impact of loneliness on psychological distress of orthopaedic patients’ caregivers has been given little research attention. The present study examined the association of loneliness with psychological health, and explored gender differences in the loneliness and psychological health association among orthopaedic patients’ caregivers. Participants were 250 patients’ caregivers drawn from a national orthopaedic hospital in eastern Nigeria. Data was collected by means of self-report measures translated into the local dialect of the caregivers. Multiple regression results showed that loneliness positively predicted psychological distress in the total sample. Loneliness did not predict psychological distress of male caregivers, but it positively predicted psychological distress of female caregivers. In order to promote orthopaedic patients caregivers’ mental health, gender-based differentials in the link between loneliness and psychological distress should be addressed by researchers and healthcare practitioners.     

Attitudes towards psychological treatment among older Australians

Reasons behind older adults' under‐utilisation of mental health services are complex. Barriers to access to mental health services for this group include service access and availability, attitudes of medical and mental health professionals, and attitudes of older people themselves. This questionnaire‐based study sought to investigate variables that may influence attitudes towards psychological help seeking among a late mid‐age–young‐old Australian sample of 159 community‐dwelling adults. The results suggest that attitudes towards seeking psychological help in this population were relatively positive. In addition, >50% of participants in the sample indicated that they had sought treatment for emotional or psychological difficulties in the past, with the greatest proportion of those who sought help noting that it was for “family problems” (56%). The findings suggest that negative attitudes to help seeking in this age group may not be as pervasive as previously assumed, and that help‐seeking behaviours may be high among those with positive attitudes towards help seeking.     

Effects of disability and bereavement on the mental health and recovery of older adults

We investigated the role of two major stressors, recent disability and conjugal bereavement, in older adults' self-reports of mental health and recovery from stress. A sample of 246 older adults between the ages of 60-80 was interviewed monthly for 3 months by trained elderly interviewers; Month-10 interview data were also analyzed. Control subjects, who were not experiencing the stressors, were carefully selected from a sample of adults matched on age, sex, and socioeconomic status. Dependent variables were psychological distress and psychological well-being, each with component subscales. The disabled group evidenced significantly lower positive well-being and significantly greater distress than did the other groups. Bereaved subjects demonstrated high levels of depression compared with the disabled subjects, but showed less anxiety. Bereaved subjects showed recovery on several indicators of mental health, but disabled subjects continued to show considerable psychological upset in comparison with the other groups.     

Social and demographic correlates of loneliness in late life

Although loneliness is often viewed as a serious problem of old age, few studies have addressed either its measurement or prevalence among older populations. The present study analyzed survey data from newspaper questionnaires circulated in three North American cities (N = 2,026) in order to examine the prevalence of loneliness across the life-span and some of its correlates in late life. Loneliness decreased across the adult life-span, with respondents age 65 and older the least lonely; elders were also more satisfied with their social relationships. Neither gender nor living alone was related to loneliness for older people. The data also partially confirm the desolation hypothesis, suggesting that desolation, or the loss of an intimate attachment, rather than isolation per se is a major correlate of loneliness in late life. Further, recency of loss was strongly related to increased loneliness. Directions for future research and intervention are discussed.     

Estimating the Mental Health Effects of Social Isolation

It is frequently hypothesized that feelings of social isolation are detrimental for an individual’s mental health, however standard statistical models cannot estimate this effect due to reverse causality between the independent and dependent variables. In this paper we present endogeneity-corrected estimates of the mental health consequences of isolation (based on self-assessed loneliness scores) using Australian panel data. The central identification strategy comes from a natural source of variation where some people within our sample are required by work or study commitments to move home. This relocation may break individuals’ social ties, resulting in significantly higher reported feelings of loneliness and consequently may lower mental health scores. The method gives results that are significant, robust and pass a battery of diagnostic tests. Estimates indicate that feelings of isolation have large negative consequences for psychological well-being, and that the effects are larger for women and older people. The results suggest that at current levels, a 10 % reduction applied to all individuals would reduce annual expenditure on mental illness in Australia by approximately $3B AUD, or around $150 AUD per person.     

Prevalence and correlates of psychological distress of middle-aged and older women living with HIV

The aims of this study were to examine the prevalence and correlates of psychological distress among older women living with HIV in comparison to their male counterparts and younger women and to identify the sociodemographic and disease-related factors associated with psychological distress. The sample consisted of 508 HIV-infected patients (65 older women, 323 women aged below 50 years, and 120 older men) recruited from 10 Portuguese hospitals. Data regarding psychological distress were collected using the Brief Symptom Inventory (BSI). Seven older women (10.8%), eight older men (6.7%), and 61 younger women (18.9%) reported a T-score ≥ 63 for global severity index (GSI), indicative of a need for further psychological evaluation. Overall, younger women reported significantly higher psychological distress than older men. The odds of having clinically significant psychological distress score were significantly lower for older women reporting sexual transmission, while for younger women, having other co-infections was a significant correlate of higher psychological distress. Younger women were 2.67 (95% CI: 1.22–5.84) times more likely to report psychological distress than were older men. The odds were not significantly different from older women. This study shows that older women do not differ substantially from younger women and older men in terms of psychological distress. The results reinforce, however, that mental health interventions should be tailored to reflect individuals’ circumstances as well as developmental contexts. Moreover, they draw attention to the importance of examining resilience characteristics in older adults to understand the mechanisms behind ‘successful ageing’ while living with HIV.     

老年人依恋对生活满意度的影响：孤独感的中介作用

选取湖北省和湖南省的六个县市的310名老年人,采用感情和社交孤独问卷(ESLS)、生活满意度量表(SWLS)和亲密关系经历量表（ECR）进行测量,运用偏差矫正百分位的非参数Bootstrap 方法探讨老年人的孤独感在依恋与生活满意度之间的中介作用。结果表明：（1）依恋的回避和焦虑两个维度均与孤独感呈显著正相关,与生活满意度呈显著负相关,孤独感与生活满意度呈显著负相关;（2）孤独感在在依恋回避与生活满意度之间起部分中介作用,在依恋焦虑与生活满意度之间起完全中介作用。     

Health-related quality of life in chronic fatigue syndrome: predictors of physical functioning and psychological distress

This study investigated health-related quality of life (HRQoL; physical functioning and psychological distress) in an Australian chronic fatigue syndrome (CFS) population. The aims of the study were to compare HRQoL in those with CFS to the normal population, and to investigate the extent to which sociodemographic (age, gender, partner status, education), illness-related (illness duration, symptom frequency), and fatigue severity (physical, mental) variables predicted HRQoL. A total of 139 people meeting CFS criteria completed questionnaires. HRQoL was assessed using standardised measures of distress and physical functioning. Compared with norms, those with CFS obtained significantly lower scores on all physical functioning areas, whereas 63% of participants reported clinically significant psychological distress. Hierarchical regression analyses indicated that physical fatigue severity and symptom frequency were the strongest predictors of deficits in physical domain HRQoL. Physical HRQoL outcomes were also predicted by mental fatigue severity, older age, and female gender. All predictors were unrelated to psychological distress apart from weak positive associations with physical fatigue and symptom frequency. Results identify a potent set of predictors of HRQoL and show that CFS has a pervasive negative impact on quality of life, particularly physical and psychological functioning.     

Lifestyle and mental health among school-going adolescents in Namibia

This study examined the association between lifestyle behaviours and psychological distress indicators among school-going adolescents. The analysis included 4 531 school children, 11–18 years of age, who completed the Namibia Global School-based Student Health Survey (GSHS) in 2013. Multivariable logistic regression analysis found that engaging in a greater number of harmful consumptive, sedentary and sexual risk behaviours carried an elevated risk for anxiety, suicide attempt and loneliness. Adolescents with co-occurring health risk behaviours have poorer mental health outcomes with socio-economic vulnerability.     

年轻男同性恋者内化同性恋嫌恶与主观幸福感的关系：自尊与孤独感的中介效应

通过网络抽样法,采用内化同性恋嫌恶量表、自尊量表、孤独感量表、主观幸福感量表对249名年轻男同性恋者进行调查,考察当代国内年轻男同性恋者内化同性恋嫌恶的现状,并探讨内化同性恋嫌恶与主观幸福感的关系及自尊与孤独感在其间的中介效应。结果表明：（1）总体上,国内年轻男同性恋者内化同性恋嫌恶处于中等偏低水平,且有较大比例年轻男同性恋者不存在内化同性恋嫌恶。（2）内化同性恋嫌恶与积极情感、生活满意度显著负相关,与消极情感显著正相关。（3）自尊与孤独感在内化同性恋嫌恶与主观幸福感间起完全中介作用。（4）内化同性恋嫌恶通过影响自尊间接影响孤独感,又通过影响孤独感作用于主观幸福感。     

Longitudinal Relationships Between Positive Affect,Loneliness, and Suicide Ideation: Age‐Specific Factors in a General Population

The aims of this study were to analyze whether positive and negative affect, social support, and loneliness are factors longitudinally related to suicide ideation in the general population in different age groups. A total of 2,392 individuals from a nationally representative sample of the Spanish general population were evaluated in 2011–2012 and in 2014–2015. After including relevant control variables in the analyses, lower positive affect was prospectively related to ideation in 18‐ to 59‐year‐old individuals, whereas feelings of loneliness were related to ideation in 60‐year‐and‐older individuals. Social support was not associated with suicide ideation in any age group. These results are in line with the need for age‐tailored suicide prevention programs. The present findings might also suggest that health care professionals should consider feelings of loneliness rather than social support to assess the presence of suicide ideation in older people.     

A Salutogenic Analysis of the Well-Being Paradox in Older Age

Following Antonovsky’s salutogenic perspective, we investigate to what extent the sense of coherence and psychological resources mediate the physical health-mental health relationship, assuming that these resilience factors mutually influence each other. In our questionnaire study, 387 older persons at the mean age of 73.8 years volunteered. We assessed physical health appraisals, sense of coherence components (comprehensibility, manageability, and meaningfulness), psychological resources (self-efficacy and self-esteem) and mental health (subjective well-being, depressive mood, and psychological health). We used structural equation modeling with latent variables and a bootstrapping method to test hypothesized mediation chains. We found (a) a significant direct effect of physical health on mental health, (b) two significant specific indirect effects of physical health on mental health, substantiating that the sense of coherence was a stronger mediator than psychological resources, and (c) two significant 3-path mediated effects. Physical health is profoundly associated with mental health. However, resilience factors such as the sense of coherence and psychological resources enable older people to maintain mental health when confronted with chronic physical health problems.     

Loneliness,ageism, and mental health: The buffering role of resilience in seniors

IntroductionAgeism and loneliness are two relevant public health phenomena because of their negative impact on the senior's mental health. With the increase in average life expectancy, these tend to co-occur, which may increase the psychological distress (PD) of seniors. Resilience has been shown to be an important protective factor of seniors mental health, although its potential buffering role of public health risk factors with cumulative impact on mental health, such as loneliness and ageism, needs to be more studied.AimTo assess the potential mediator role of resilience between the effects of ageism and loneliness on PD in seniors.MethodsA sample of 349 Portuguese seniors aged 60 years and over was collected through an online survey and during the COVID-19 pandemic period. Seniors completed the Kessler Psychological Distress Scale (K6), the Short-Form of UCLA Loneliness Scale (USL-6), the Ambivalent Ageism Scale (AAS) and the Connor-Davidson Resilience Scale (CD-RISC-10). A mediation analysis model was developed with resilience as a mediating variable.ResultsThere were moderate to high levels of PD and moderate levels of ageism, loneliness and resilience. Resilience fully mediated the effect of ageism on PD and partially mediated the effect of loneliness on PD.ConclusionsResilience was an important protective factor of mental health against the effects of ageism, and partially protected mental health from the effects of loneliness among seniors. It is suggested that resilience be considered as a factor to be integrated in future intervention programs for mental health. The practical applicability of this study is discussed.     

Unemployment impairs mental health: Meta-analyses

The effect of unemployment on mental health was examined with meta-analytic methods across 237 cross-sectional and 87 longitudinal studies. The average overall effect size was d = 0.51 with unemployed persons showing more distress than employed persons. A significant difference was found for several indicator variables of mental health (mixed symptoms of distress, depression, anxiety, psychosomatic symptoms, subjective well-being, and self esteem). The average number of persons with psychological problems among the unemployed was 34%, compared to 16% among employed individuals. Moderator analyses demonstrated that men and people with blue-collar-jobs were more distressed by unemployment than women and people with white-collar jobs. Linear and curvilinear moderating effects of the duration of unemployment were also identified. Furthermore, the negative effect of unemployment on mental health was stronger in countries with a weak level of economic development, unequal income distributions, or weak unemployment protection systems compared to other countries. Meta-analyses of longitudinal studies and natural experiments endorsed the assumption that unemployment is not only correlated to distress but also causes it. Seemingly inconsistent longitudinal results of older meta-analyses can be explained by retest artifacts. We also identified mental-health related selection effects during job loss and job search, but they are weak. With an effect size of d = −.35 intervention programs for unemployed people were found to be moderately effective in ameliorating unemployment-related distress among continuously unemployed persons.     

Predicting the psychological health of older adults: Interaction of age-based rejection sensitivity and discriminative facility

We hypothesize that older adults who anxiously expect, readily perceive, and intensely react to social rejection because of their old age (i.e., have high age-based rejection sensitivity) are vulnerable to depression and poor social functioning. We further hypothesize that the association between age-based rejection sensitivity and poor psychological health would be attenuated among older adults who possess adequate cognitive coping ability—they can discern and respond discriminatively to subtle variations in situational demands (i.e., have high discriminative facility). Based on the results of a focus group study, we constructed an age-based rejection sensitivity measure, which predicts greater depression, poorer social functioning, greater loneliness, and lower life satisfaction among individuals in late adulthood. As hypothesized, the relationship between age-based rejection sensitivity and poor psychological health was weaker among older adults with high (vs. low) discriminative facility.     

The prevalence of loneliness among adults: a case study of the United Kingdom

Within contemporary Western (post) modern societies, loneliness is seen as a problem that is particularly associated with old age. Much less attention has been given to examining variations in loneliness across age groups. We examine patterns of loneliness across adults aged 15 years and older in the United Kingdom using data from the European Social Survey. We first consider the prevalence of loneliness among the adult population; then the relationship between loneliness and a range of key risk factors, and finally the relationship with age for each of our risk factors. Loneliness demonstrates a nonlinear U-shaped distribution, with those aged under 25 years and those aged over 65 years demonstrating the highest levels of loneliness. Depression is associated with loneliness for all age groups. Poor physical health is associated with loneliness in young adult and midlife but not later life. For those in mid and later life, the quality of social engagement is protective against loneliness, while for young adults it is the quantity of social engagement. This indicates that different factors may endow vulnerability (or protect) against loneliness at different stages of life and suggests that preventative strategies or interventions that reflect these variations need to be developed.     

Positive affect and distressed affect over the day in older people

The purpose of this study was to assess patterns of affect over the day in a representative sample of older people, with particular emphasis on the impact of loneliness and depression. Momentary assessments of positive and distressed affect were obtained four times over a single day from 4,258 men and women aged 52-79 years from the English Longitudinal Study of Ageing. Positive and distressed affect were only modestly correlated (r = -0.23). Positive affect was low on waking and peaked in the early evening, while distressed affect decreased progressively over the day. The diurnal variation in positive affect was greater in participants <65 years compared with older individuals. Positive affect was greater in men, married participants and in healthy individuals, while distressed affect was higher among women, unmarried and lower socioeconomic status respondents, and in those with limiting longstanding illnesses. Depressed individuals experienced lower positive affect throughout the day, while differences in distressed affect were more pronounced in the morning. Loneliness was associated with lower positive affect and greater distressed affect independently of age, sex, marital status, paid employment, socioeconomic status, health, and depression. This study demonstrates that ecological momentary assessment of affect is feasible on a large scale in older individuals, and generates information about positive affect and distress that is complementary to standard questionnaire measures. The associations with loneliness highlight the everyday distress and reduced happiness and excitement experienced by lonely older men and women, and these may contribute to enhanced risks to physical and mental health.     

Seeking help when transgender: Exploring the difference in mental and physical health seeking behaviors between transgender and cisgender individuals in Ireland

Abstract

Background: While there is growing awareness of the need to support the physical and mental wellbeing of transgender people, some may be reluctant to seek help from healthcare professionals. Little is understood about the mechanisms that influence help-seeking behavior in this group.

Aims: This study aimed to compare transgender and cisgender participants in their likelihood to seek help for both physical and mental health conditions, and to explore whether this help-seeking behavior is predicted by a range of sociodemographic and psychological variables.

Methods: 123 participants living in Ireland (cisgender= 67; transgender= 56) completed a questionnaire which included demographic questions, as well as measures of optimism (LOT-R), self-esteem (RSES), psychological distress (GHQ-12), attitudes towards seeking psychological help (ATSPPH-SF), and attitudes towards seeking help for a physical health problem (Attitudes Towards Seeking Medical Help Scale- Action/Intervention subscale). Associations between predictor variables and mental and physical health seeking were explored using correlation analysis and stepwise regressions.

Results: Transgender participants were less likely to seek help for a physical health issue than cisgender participants, but did not differ in mental health help-seeking behaviors. Results suggest that this may be due to differences in optimism, self-esteem and psychological distress. Transgender participants had significantly lower optimism and self-esteem, which were two factors linked to poorer physical health seeking behaviors. Optimism also emerged as a significant predictor in mental health seeking behaviors.

Discussion: The lack of a significant difference for mental health help-seeking between the transgender and cisgender participants is encouraging, as it suggests that there is less stigma surrounding mental illness than expected, however findings also contradict previous findings suggesting that physical health is less stigmatized. This could be due to stigma relating to gender-specific healthcare and suggests that healthcare professionals should acknowledge the specific healthcare needs and concerns among transgender individuals.     

Psychological and socioeconomic health of community‐dwelling older adults

Different dimensions of health are intertwined. The purposes of this study were: (1) to investigate the psychological and socioeconomic health status of community‐dwelling older adults in Taiwan, and (2) to compare the psychological and socioeconomic health differences among people of different age groups, gender, marital status, and exercise habits. Using stratified random sampling, 384 Taiwanese community‐dwelling older adults were recruited for this survey research. Based on the Health Model of Older Adults, seven constructs were measured: (1) psychological health: sleep quality, emotional health, cognitive functioning, and health promotion behaviors; (2) socioeconomic health: social engagement, social support, and financial status. Results showed that most participants were in a good state of psychological and socioeconomic health, except that 38.02% of them suffered from sleep disruptions, and the majority of them were not involved in any social group, nor engaged in any volunteer work. Young‐old older adults had better psychological and socioeconomic health than middle‐old and old‐old older adults. Male older adults had better psychological health than female older adults; however, they had less social engagement and social support than female older adults. Married older adults and exercisers performed better in most of the psychological and socioeconomic health indicators than single/widowed older adults and non‐exercisers.